When You Know What You “Should” Do (But Knowing Isn’t The Problem)
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When knowing what to do isn’t the problem
Often, we know what we need to do. Sometimes, knowing isn’t the problem!
The topic today is going to be a technique used by therapeutic service providers to help people to enact positive changes in their lives.
While this is a necessarily dialectic practice (i.e., it involves a back-and-forth dialogue), it’s still perfectly possible to do it alone, and that’s what we’ll be focussing on in this main feature.
What is Motivational Interviewing?
❝Motivational interviewing (MI) is a technique that has been specifically developed to help motivate ambivalent patients to change their behavior.❞
Read in full: Motivational Interviewing: An Evidence-Based Approach for Use in Medical Practice
It’s mostly used for such things as helping people reduce or eliminate substance abuse, or manage their weight, or exercise more, things like that.
However, it can be employed for any endeavour that requires motivation and sustained willpower to carry it through.
Three Phases
Motivational Interviewing traditionally has three phases:
- Exploring and understanding the issue at hand
- Guiding and deciding importance and goals
- Choosing and setting an action plan
In self-practice, maybe you can already know and understand what it is that you want/need to change.
If not, consider asking yourself such questions as:
- What does a good day look like? What does a bad day look like?
- If things are not good now, when were they good? What changed?
- If everything were perfect now, what would that look like? How would you know?
Once you have a clear idea of where you want to be, the next thing to know is: how much do you want it? And how confident are you in attaining it?
This is a critical process:
- Give your answers numerically on a scale from 0 to 10
- Whatever your score, ask yourself why it’s not lower. For example, if you scored your motivation 4 and your confidence 2, what factors made your motivation not a lower number? What factors made your confidence not a lower number?
- In the unlikely event that you gave yourself a 0, ask whether you can really afford to scrap the goal. If you can’t, find something, anything, to bring it to at least a 1.
- After you’ve done that, then you can ask yourself the more obvious question of why your numbers aren’t higher. This will help you identify barriers to overcome.
Now you’re ready to choose what to focus on and how to do it. Don’t bite off more than you can chew; it’s fine to start low and work up. You should revisit this regularly, just like you would if you had a counsellor helping you.
Some things to ask yourself at this stage of the motivational self-interviewing:
- What’s a good SMART goal to get you started?
- What could stop you from achieving your goal?
- How could you overcome that challenge?
- What is your backup plan, if you have to scale back your goal for some reason?
A conceptual example: if your goal is to stick to a whole foods Mediterranean diet, but you are attending a wedding next week, then now is the time to decide in advance 1) what personal lines-in-the-sand you will or will not draw 2) what secondary, backup plan you will make to not go too far off track.
The same example in practice: wedding menus often offer meat/fish/vegetarian options, so you might choose the fish or vegetarian, and as for sugar and alcohol, you might limit yourself to “a small slice of wedding cake only; coffee/cheese option instead of dessert”, and “alcohol only for toasts”.
Giving yourself the permission well in advance for small (clearly defined and boundaried!) diversions from the plan, will stop you from falling into the trap of “well, since today’s a cheat-day now…”
Secret fourth stage
The secret here is to keep going back and reassessing at regular intervals. Set your own calendar; you might want to start out weekly and then move to monthly when you’re more strongly on-track.
For this reason, it’s good to keep a journal with your notes from your self-interview sessions, the scores you gave yourself, the goals and plans you set, etc.
When conducting your regular review, be sure to examine what worked for you, and what didn’t (and why). That way, you can practice trial-and-improvement as you go.
Want to learn more?
We only have so much room here, but there are lots of resources out there.
Here’s a high-quality page that:
- explains motivational interviewing in more depth than we have room for here
- offers a lot of free downloadable resource packs and the like
Check it out: Motivational Interviewing Theory & Resources
Enjoy!
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Common Hospital Blood Pressure Mistake (Don’t Let This Happen To You Or A Loved One)
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There’s a major issue in healthcare, Dr. Suneel Dhand tells us, pertaining to the overtreatment of hypertension in hospitals. Here’s how to watch out for it and know when to question it:
Under pressure
When patients, particularly from older generations, are admitted to the hospital, their blood pressure often fluctuates due to illness, dehydration, and other factors. Despite this, they are often continued on their usual blood pressure medications, which can lead to dangerously low blood pressure.
Why does this happen? The problem arises from rigid protocols that dictate stopping blood pressure medication only if systolic pressure is below a certain threshold, often 100. However, Dr. Dhand argues that 100 is already low*, and administering medication when blood pressure is close to this can cause it to drop dangerously lower
*10almonds note: low for an adult, anyway, and especially for an older adult. To be clear: it’s not a bad thing! That is the average systolic blood pressure of a healthy teenager and it’s usually the opposite of a problem if we have that when older (indeed, this very healthy writer’s blood pressure averages 100/70, and suffice it to say, it’s been a long time since I was a teenager). But it does mean that we definitely don’t want to take medications to artificially lower it from there.
Low blood pressure from overtreatment can lead to severe consequences, requiring emergency interventions to stabilize the patient.
Dr. Dhand’s advice for patients and families is:
- Ensure medication accuracy: make sure the medical team knows the correct blood pressure medications and dosages for you or your loved one.
- Monitor vital signs: actively check blood pressure readings, especially if they are in the low 100s or even 110s, and discuss any medication concerns with the medical team.
- Watch for symptoms of low blood pressure: be alert for symptoms like dizziness or weakness, which could indicate dangerously low blood pressure.
For more on all of this, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
The Insider’s Guide To Making Hospital As Comfortable As Possible
Take care!
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SMOL Bowl With Sautéed Greens
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Whole grains are good, and gluten is bad for some people. Today’s dish has four whole grains, and no gluten (assuming no cross-contamination, so look for the gluten-free label if that’s important to you). Breafast? Brunch? Lunch? Supper, even? This is good at any time of day, packed with nutrients and full of flavor!
You will need (per person)
- 1 cup mixed cooked grains of equal parts sorghum, millet, oats, lentils (SMOL)—these can be cooked in bulk in advance and frozen in portions, as it’s often good to used mixed grains, and these four are a great combination for many purposes.
- ½ cup low sodium vegetable stock (ideally you made this yourself from vegetable offcuts you kept in the freezer until you had enough for this purpose, but failing that, low-sodium stock cubes can be bought at most large supermarkets).
- ½ cup finely chopped red onion
- 6 oz cavolo nero, finely chopped
- 1 small carrot, finely chopped
- 3 cloves garlic, finely chopped
- 1 tbsp nutritional yeast
- 1 tsp black pepper, coarse ground
- 1 tsp white miso paste
- To serve: 1 lemon wedge
Method
(we suggest you read everything at least once before doing anything)
1) Add the stock to a sauté pan over a medium heat, and add the onion, garlic, and carrot. Stir frequently for about 7 minutes.
2) Add the cavolo nero and miso paste, stirring for another 4 minutes. If there is any liquid remaining, drain it off now.
3) Warm the SMOL mixture (microwave is fine) and spoon it into a bowl, topping with the nutritional yeast and black pepper. Finally, add the hot cavolo nero mixture.
4) Serve with the lemon wedge on the side, to add a dash of lemon at will.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
Take care!
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Power Vegan Meals – by Maya Sozer
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This book has inspired some of the recipes we’ve shared recently—we’ve invariably tweaked and in our opinion improved them, but the recipes are great as written too.
The recipes, of which there are 75, are all vegan, gluten-free, high protein, and high fiber. Some reviewers on Amazon have complained that the recipes are high-calorie, and they often are, but those calories are mostly from healthy fats, so we don’t think it’s a bad thing. Still, if you’re doing a strict calorie-controlled diet, this is probably not the one for you.
Another thing the recipes are is tasty without being unduly complicated, as well as being mostly free from obscure ingredients. This latter is a good thing not because obscure ingredients are inherently bad, but rather that it can be frustrating to read a recipe and find its star ingredient is a cup of perambulatory periannath that must be harvested from the west-facing slopes of Ithilien during a full moon, no substitutions.
The style and format is simple and clear with minimal overture, one recipe per double-page; picture on one side, recipe on the other; perfect for a kitchen reading-stand.
Bottom line: these recipes are for the most part very consistent with what we share here, and we recommend them, unless you’re looking for low-calorie options.
Click here to check out Power Vegan Meals, and power-up your vegan meals!
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Life Lessons From A Brain Surgeon – by Dr. Rahul Jandial
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In the category of surgeons with a “what to put on your table to stay off mine” angle, this book packs an extra punch. As well as being an experienced brain surgeon, Dr. Jandial also does a lot of cutting edge lab research too. What does this mean for us?
This book gives, as the subtitle promises, “practical strategies for peak health and performance”—with a brain-centric bias, of course.
From diet and nootropic supplements, to exercise and brain-training, we get a good science-based view of which ones actually work, and which don’t. The style is also very readable; Dr. Jandial is a great educator, presenting genuine scientific content with very accessible language.
Bottom line: if you’d indeed like to look after your most important organ optimally, this book gives a lot of key pointers, without unnecessary fluff.
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Wholesome Threesome Protein Soup
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This soup has two protein– and fiber-rich pseudo-grains, one real wholegrain, and nutrient-dense cashews for yet even more protein, and all of the above are full of many great vitamins and minerals. All in all, a well-balanced and highly-nutritious light meal!
You will need
- ⅓ cup quinoa
- ⅓ cup green lentils
- ⅓ cup wholegrain rice
- 5 cups low-sodium vegetable stock (ideally you made this yourself from offcuts of vegetables, but failing that, low-sodium stock cubes can be bought in most large supermarkets)
- ¼ cup cashews
- 1 tbsp dried thyme
- 1 tbsp black pepper, coarse ground
- ½ tsp MSG or 1 tsp low-sodium salt
Optional topping:
- ⅓ cup pine nuts
- ⅓ cup finely chopped fresh mint leaves
- 2 tbsp coconut oil
Method
(we suggest you read everything at least once before doing anything)
1) Rinse the quinoa, lentils, and rice.
2) Boil 4 cups of the stock and add the grains and seasonings (MSG/salt, pepper, thyme); simmer for about 25 minutes.
3) Blend the cashews with the other cup of vegetable stock, until smooth. Add the cashew mixture to the soup, stirring it in, and allow to simmer for another 5 minutes.
4) Heat the coconut oil in a skillet and add the pine nuts, stirring until they are golden brown.
5) Serve the soup into bowls, adding the mint and pine nuts to each.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Give Us This Day Our Daily Dozen
- Black Pepper’s Impressive Anti-Cancer Arsenal (And More)
- Why You Should Diversify Your Nuts!
Take care!
Don’t Forget…
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How Are You, Really? And How Old Is Your Heart?
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How Are You, Really? The Free NHS Health Test
We took this surprisingly incisive 10-minute test from the UK’s famous National Health Service—the test is part of the “Better Health” programme, a free-to-all (yes, even those from/in other countries) initiative aimed at keeping people healthy enough to have less need of medical attention.
As one person who took the test wrote:
❝I didn’t expect that a government initiative would have me talking about how I need to keep myself going to be there for the people I love, let alone that a rapid-pace multiple-choice test would elicit these responses and give personalized replies in turn, but here we are❞
It goes beyond covering the usual bases, in that it also looks at what’s most important to you, and why, and what might keep you from doing the things you want/need to do for your health, AND how those obstacles can be overcome.
Pretty impressive for a 10-minute test!
Is Your Health Above Average Already? Take the Free 10-minute NHS test now!
How old are you, in your heart?
Poetic answers notwithstanding (this writer sometimes feels so old, and yet also much younger than she is), there’s a biological answer here, too.
Again free for the use of all*, here’s a heart age calculator.
*It is suitable for you if you are aged 30–95, and do not have a known complicating cardiovascular disease.
It will ask you your (UK) postcode; just leave that field blank if you’re not in the UK; it’ll be fine.
How Old Are You, In Your Heart? Take the Free 10-minute NHS test now!
(Neither test requires logging into anything, and they do not ask for your email address. The tests are right there on the page, and they give the answers right there on the page, immediately)
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